[Multidisciplinary Therapy Mainly Including Surgery for Hemorrhage Due to Duodenal Invasion of Pancreatic Cancer-A...

A 55-year-old man was admitted to our hospital with severe anemia. The cause of anemia was hemorrhage due to the duodenal invasion of pancreatic cancer. Endoscopic hemostasis was not applicable and effect of transarterial catheter embolization was temporary. Emergency surgery was chosen as the only alternative. The tumor directly invaded the mesenterium of the transverse colon and the superior mesenteric vein(SMV)widely. Pancreaticoduodenectomy, right hemicolectomy, and resection of the SMV were performed. Concerning the both resected margins, the hepatic side was simply closed without reconstruction and the caudal side was anastomosed to the left renal vein. In the perioperative period, a diffuse bleeding occurred in the site of gastrojejunostomy and endoscopic hemostasis was done successfully. There were no complications related to modification of the SMV perfusion. The patient was discharged at the 19th postoperative day. Regardless of administration of gemcitabine as adjuvant chemotherapy, he died of developing cancerous peritonitis 3 months after the surgery. Through this experience, we would like to evaluate the significance of multidisciplinary therapy including surgery for hemorrhage due to pancreatic cancer.